EAQ Quiz: Chapter 16, Care of Patients With Hematologic Disorders
Which information would the nurse include when teaching a patient with a discharge instruction to take iron supplements? (Select all that apply. One, some, or all responses may be correct.) 1) "Antacids interfere with the absorption of iron." 2) "Vitamin C interferes with the absorption of iron." 3) "Increase daily fluids because of the risk for diarrhea." 4) "Take iron with orange juice to assist with absorption." 5) "Milk fortified with vitamin D assists absorption of iron more readily."
"Antacids interfere with the absorption of iron." "Take iron with orange juice to assist with absorption."
Which response by the parents of a 6-year-old patient recently diagnosed with hemophilia indicates appropriate knowledge of the child's disease? 1) "We keep our CPR up to date at all times." 2) "We carry an EpiPen with us all the time." 3) "We administer the monthly vitamin B12 shot." 4) "If he bleeds, he will need to have the replacement factor."
"If he bleeds, he will need to have the replacement factor."
Which patient statement would concern the nurse providing care for a patient with hemophilia? 1) "I eat a lot of red meat." 2) "If my pain increases, I can take aspirin." 3) "I understand that my sister could pass this on to her son." 4) "I make sure that I do not participate in any contact sports."
"If my pain increases, I can take aspirin."
Which clinical manifestation would the nurse associate with a patient who has polycythemia vera? 1) A patient with pallor and activity intolerance 2) A thin patient with a pale complexion 3) A patient with hypotension and syncope 4) A patient with a reddish face appearance
A patient with a reddish face appearance
Which type of blood transfusion would the patient receive when stating, "I've already donated my own blood in case I need a transfusion during my joint replacement surgery"? 1) Autologous 2) Leukapheresis 3) Cryoprecipitate 4) Fresh Frozen Plasma
Autologous
Which transfusion option would the nurse discuss with a patient who practices the Jehovah's Witness religion and the surgeon has a concern about potential blood loss during the planned cardiac surgery? 1) Platelet transfusion 2) Allogenic transfusion 3) Autologous transfusion 4) Cryoprecipitate transfusion
Autologous transfusion
Which clinical manifestation would the nurse monitor for potential development in a patient who is at risk for circulatory overload after receiving a blood transfusion 2 hours ago? 1) Dyspnea 2) Back pain 3) Bradycardia 4) Increased temperature
Dyspnea
When a patient with sickle cell anemia complains of experiencing a crisis at least once a week and wants to reduce the frequency, which treatment would the nurse anticipate the primary health care provider prescribing? 1) Oxygen therapy 2) Hydroxyurea 3) Erythropoietin 4) Intravenous (IV) morphine
Hydroxyurea
Which focus of care would the nurse evaluate when providing care for a patient with pernicious anemia? 1) Maintenance of monthly phlebotomy appointments 2) Ensuring administration of monthly B12 injections for life 3) Obtaining positive Coombs test results on a scheduled basis 4) Interventions related to an increased risk for aplastic anemia
Ensuring administration of monthly B12 injections for life
When teaching a patient with thrombocytopenia about medications, which medications would the nurse advise the patient to avoid? Select all that apply. One, some, or all responses may be correct. 1) Aspirin 2) Contact sports 3) Iron supplements 4) Anticoagulant therapy 5) Nonsteroidal anti-inflammatory drugs (NSAIDs)
Aspirin Contact sports Anticoagulant therapy Nonsteroidal anti-inflammatory drugs (NSAIDs)
After consulting with the patient's dietician regarding an oral iron supplement, which liquid would the nurse request to increase absorption of the medication? 1) Tea 2) Milk 3) Coffee 4) Orange juice
Orange juice
Which clinical manifestation would the nurse report immediately when providing care for a patient with severe anemia who is receiving a blood transfusion? 1) Euphoria 2) Pain in the lower back 3) Temperature of 100°F 4) Decreased urine output
Pain in the lower back
Which clinical manifestations would the nurse associate with severe anemia? (Select all that apply. One, some, or all responses may be correct.) 1) Pallor 2) Tachypnea 3) Bradycardia 4) Smooth nails 5) Smooth tongue
Pallor Tachypnea Smooth tongue
Which example would the nurse provide for a patient who is experiencing disseminated intravascular coagulation (DIC) and asks about the pathologic cause of the disorder? 1) Sepsis 2) Anemia 3) Hemophilia 4) Minor trauma
Sepsis
When a middle-aged adult with a history of anemia tells the nurse about "having trouble getting through the day lately," which symptom would the nurse expect the patient to report to the primary health care provider? 1) Lymphadenopathy 2) Shortness of breath 3) Nausea and vomiting 4) Fatigue upon awakening
Shortness of breath
Which content would the nurse include when providing discharge instructions for a patient with multiple myeloma? 1) "Obtain and document an apical pulse daily." 2) "Increase dietary calcium intake daily." 3) "Limit fluid intake to 1 L to 2 L/day." 4) "Obtain assistance when moving to prevent fractures."
"Obtain assistance when moving to prevent fractures."
Which characteristics would the nurse associate with hemophilia? (Select all that apply. One, some, or all responses may be correct.) 1) A deficiency of factor IX 2) A deficiency of factor XI 3) A deficiency of factor VIII 4) An inherited X-linked disorder 5) An inherited Y-linked disorder
A deficiency of factor IX A deficiency of factor VIII An inherited X-linked disorder
When monitoring a patient receiving a blood transfusion, which intervention would the nurse anticipate implementing after notifying the health care provider of the patient's new rash and itching at the intravenous insertion site? 1) Administer diuretics. 2) Administer antipyretics. 3) Prepare patient for dialysis. 4) Administer diphenhydramine hydrochloride.
Administer diphenhydramine hydrochloride.
Which intervention would the nurse implement after the charge nurse immediately stops a transfusion for a patient receiving a second unit of blood who becomes short of breath and has distended neck veins? 1) Administering oxygen and furosemide 2) Administering epinephrine and steroid agents 3) Providing supportive therapy to maintain heart rate and blood pressure 4) No intervention because the patient does not require additional treatment
Administering oxygen and furosemide
Which laboratory results would the nurse expect when a patient with a history of extreme fatigue, spontaneous nosebleeds, and frequent infections also has shortness of breath, pulse of 104 beats/min, and a blood pressure of 90/60 mm Hg? 1) RBCs 4.5, WBCs 3500, and platelets 95,000 2) RBCs 3.7, WBCs 4000, and platelets 80,000 3) RBCs 3.8, WBCs 4500, and platelets 100,000 4) RBCs 4.6, WBCs 5000, and platelets 125,000
Aplastic anemia signs/symptoms RBCs 3.7, WBCs 4000, and platelets 80,000
Which standards of care would the nurse monitor to ensure a safe and effective transfusion when assisting in administration of a patient's blood transfusion? (Select all that apply. One, some, or all responses may be correct.) 1) Blood transfusion tubing includes a special blood filter. 2) Monitor the patient closely after blood transfusion for any changes. 3) Ensure that transfusion occurs within 5 hours after removal from refrigeration. 4) Ensure that transfusion of the blood occurs after verifying the patient's identification. 5) Remove the blood from refrigeration 1 hour before beginning the transfusion.
Blood transfusion tubing includes a special blood filter. Monitor the patient closely after blood transfusion for any changes. Ensure that transfusion of the blood occurs after verifying the patient's identification.
The nurse understands that the scope of practice for all licensed practical/vocational nurses (LPN/LVNs) regarding blood transfusion includes which responsibilities? (Select all that apply. One, some, or all responses may be correct.) 1) Checking the blood with the registered nurse (RN) 2) Obtaining blood from the blood bank 3) Monitoring the patient during transfusion 4) Stopping the transfusion if any sign of reaction is observed 5) Starting the blood within 30 minutes of arrival to the scene
Checking the blood with the registered nurse (RN) Obtaining blood from the blood bank Monitoring the patient during transfusion Stopping the transfusion if any sign of reaction is observed
Which clinical manifestations would the nurse associate with an acute hemolytic transfusion reaction? (Select all that apply. One, some, or all responses may be correct.) 1) Chills 2) Fever 3) Bradycardia 4) Hypertension 5) Low back pain
Chills Fever Low back pain
Which characteristics would the nurse associate with aplastic anemia? Select all that apply. One, some, or all responses may be correct. 1) Decreased B12 2) Increased pain 3) Increased platelets 4) Decreased red blood cells 5) Decreased white blood cells
Decreased red blood cells Decreased white blood cells
Which disorder would the nurse identify as a grave complication when the patient experiences bleeding and intravascular clotting at the same time? 1) Thrombocytopenia 2) Multiple myeloma 3) Von Willebrand disease 4) Disseminated intravascular coagulation (DIC)
Disseminated intravascular coagulation (DIC)
Which responses would the nurse utilize when a patient diagnosed with leukemia asks what could have caused the disease? (Select all that apply. One, some, or all responses may be correct.) 1) Exposure to ionizing radiation 2) Human T-lymphotropic virus 1 3) An abnormal number of chromosomes 4) Enlargement of the lymph glands 5) Chemicals that are toxic to the bone marrow
Exposure to ionizing radiation Human T-lymphotropic virus 1 An abnormal number of chromosomes Chemicals that are toxic to the bone marrow
Which clinical manifestations would the nurse associate with a patient diagnosed with leukemia? (Select all that apply. One, some, or all responses may be correct.) 1) Increased white blood cells 2) Decreased white blood cells 3) Possible link to benzene exposure 4) Possible link to intrinsic factor exposure 5) A hemolytic genetic disorder inherited from both parents
Increased white blood cells Possible link to benzene exposure
Which teaching point would the nurse identify in the plan of care for a patient recently diagnosed with thrombocytopenia? 1) Instruct the patient to avoid crowds. 2) Instruct the patient to increase fluid intake. 3) Instruct the patient to use a soft toothbrush. 4) Instruct the patient to alternate periods of activity with periods of rest.
Instruct the patient to use a soft toothbrush.
The nurse understands that the patient with megaloblastic (pernicious) anemia has which deficiencies? (Select all that apply. One, some, or all responses may be correct.) 1) Erythropoietin 2) Intrinsic factor 3) Ferrous sulfate 4) Cyanocobalamin 5) White blood cells
Intrinsic factor Cyanocobalamin
Patients with hypochromic, microcytic anemia need to increase their intake of which nutrient? 1) B12 2) Iron 3) Vitamin D 4) Cyanocobalamin
Iron
Which intervention would the nurse identify in the plan of care when the laboratory report reflects an increase in the uric acid level for a patient receiving chemotherapy for leukemia? 1) Maintaining adequate hydration 2) Performing meticulous mouth care 3) Holding the next dose of chemotherapy and contact the health care provider 4) Encouraging the patient to alternate periods of activity with periods of rest
Maintaining adequate hydration
Which type of anemia would the nurse associate with the patient experiencing neurologic clinical manifestations? 1) Aplastic anemia 2)Sickle cell anemia 3) Megaloblastic anemia 4) Iron deficiency anemia
Megaloblastic anemia
Which condition would the nurse include in the teaching for a patient diagnosed with an excessive production of red blood cells? 1) Leukemia 2) Leukocytosis 3) Thrombocytopenia 4) Polycythemia vera
Polycythemia vera
Which disorder would the nurse associate with a patient who presents to the clinic with a reddish complexion and complains of dizziness, headache, and fatigue? 1) Leukemia 2) Anaphylaxis 3) Polycythemia vera 4) Thrombocytopenia
Polycythemia vera
Which clinical manifestations would the nurse anticipate when providing care for a patient with thrombocytopenia? (Select all that apply. One, some, or all responses may be correct.) 1) Purpura 2) Stomatitis 3) Ecchymoses 4) Defective S hemoglobin 5) Gastrointestinal bleeding
Purpura Ecchymoses Gastrointestinal bleeding
Which clinical manifestation would alert the nurse to a potential problem when the patient begins to hemorrhage from an incision during the immediate postoperative period? 1) Flushed, hot skin 2) Rapid, weak pulse 3) Increased urine output 4) Rising systolic blood pressure
Rapid, weak pulse
Which intervention would the nurse implement when the patient receiving a blood transfusion complains of fever, chills, lower back pain, and chest tightness? 1) Stopping the blood transfusion process 2) Maintaining airways through suctioning 3) Notifying the primary health care provider 4) Positioning the patient in the supine position
Stopping the blood transfusion process
Which characteristics would the nurse associate with an assigned patient with sickle cell anemia? (Select all that apply. One, some, or all responses may be correct.) 1) The disorder is hereditary. 2) Sickle cell anemia is an acquired anemia. 3) The disease is usually asymptomatic. 4) The disease is a result of abnormal hemoglobin. 5) Generally, the disorder results in increased hemoglobin levels.
The disorder is hereditary. The disease is a result of abnormal hemoglobin.
When participating in a patient care planning conference regarding an autologous bone marrow transplantation, the nurse understands that the plan of care includes preparing the patient for a transplant from which source? 1) An animal 2) The patient 3) Another person 4) A twin or sibling
The patient
Which unique characteristics would the nurse link to a patient with sickle cell disease? (Select all that apply. One, some, or all responses may be correct.) 1) There is no cure for this disease. 2) Extreme pain occurs during a crisis. 3) Sickle cell patients have abnormally shaped red blood cells. 4) Adequate hydration can cause a crisis. 5) Leukapheresis is a common treatment.
There is no cure for this disease. Extreme pain occurs during a crisis. Sickle cell patients have abnormally shaped red blood cells.
Which frequently used therapy would the nurse explain when teaching a patient with a hematologic disorder? (Select all that apply. One, some, or all responses may be correct.) 1) Transfusions 2) Splenectomy 3) Erythropheresis 4) Magnesium therapy 5) Stem cell transplantation
Transfusions Splenectomy Stem cell transplantation